Getting an IUD: What to Expect and One Thing That Can Make a Huge Difference

Updated November 2018

So you’ve evaluated your birth control options and settled on an IUD — welcome to the club! IUDs are a reliable, effective, set-it-and-forget-it option that’s become increasingly popular with millennial women. But no matter how confident you are in your choice, it’s natural to feel some trepidation about the procedure involved. If you’ve googled “IUD insertion painful?” you’re not alone — and possibly more confused than ever. Women report feeling everything from mild cramping to “worse than childbirth.” How can you know how it’ll feel for you?

How painful the IUD experience is for you will greatly depend on your body and sensitivity. For those of you who are more sensitive, though, listen up. I’m also very sensitive and yet I’ve survived the IUD insertion twice — and one thing made a massive difference in how much pain I experienced.

I got my first IUD a little over a year ago. Because I get migraines and hormones make me moody, I went with the ParaGard. I was pretty blasé about the procedure beforehand. “Oh, but I get such bad cramps as it is, my body’s prepared for anything,” I thought. “I’ve had a UTI turn into a kidney infection, nothing can be worse than that,” I thought. I didn’t even take an Advil before the appointment, just swanned in full of hubris.

The procedure begins with the doctor measuring your uterus so they can determine where to place the IUD. For this, they use a “uterine sound,” or a bulbous-tipped probe. This felt, to me, like someone had stuck a hot poker inside of me — and that’s when I fainted, before the real insertion had even begun.

The doctor did then try to convince me I had other options, that I didn’t need to go through with the procedure, but I was determined. I knew the ParaGard was the best option for me and that I could stand a few minutes of — admittedly excruciating — pain in exchange for 10 years of 99% effective birth control. And so I white-knuckled and sobbed through the remainder of the procedure and gratefully accepted the doctor’s offer of water and a lollipop when it was all over. Then I went home and spent a few days recuperating in bed with Gilmore Girls reruns and the Montmaray Diaries. (Excellent comfort food.)

But I’d been right. The IUD had been worth the pain. Sure, the first few months came with heavier periods, but I loved the freedom the ParaGard gave me: from worrying about pregnancy, from mood swings, from remembering to buy condoms. So when I discovered a year in that my IUD had shifted slightly and needed to be replaced nine years ahead of schedule, booking the appointment was a no-brainer.

Unlike the first insertion, though, I now knew what to expect. To say I was anxious about undergoing that level of pain again is an understatement. I pretty much started crying the minute I woke up the morning of my second insertion.

And the pain started early in the procedure again, this time when they removed my original ParaGard. In retrospect, this wasn’t that painful, but it was enough of a shadow of the remembered pain that I immediately burst into tears. It was very unbecoming and obviously alarmed the poor doctor. But we had a good chat about my fears, and she offered up the solution that made all the difference.

“Why don’t we try some local anesthesia?” she suggested.

So the doctor injected a bit of anesthesia into my cervix, which felt like nothing more than a quick pinch. I lay there, totally bewildered, as she measured my uterus again — nothing, no pain at all. Then she did the actual insertion — again, I didn’t feel a thing!

After my earlier hysterics, I felt very silly and apologetic. But part of me was also annoyed. Why on earth wouldn’t local anesthesia be standard procedure for IUD insertion, especially since it does cause a lot of women a lot of pain? Why hadn’t I even known it was an option from the start? This information could have saved me a lot of anxiety, on top of the physical pain.

Of course, doctors are the experts and may have a very good reason for not offering local anesthesia. But if you’re nervous about your IUD insertion or are halfway through and find it unbearable, it never hurts to ask. And now, unlike me, you’ll know to ask!